1. Field of Invention
This invention relates to measuring the quality of health care delivered, and, more specifically, measuring patient outcomes with respect to changes in a patient's quality of life as a result of an episode of illness or injury and its treatment.
2. Prior Art
The prior art of record identified by the examiner of the parent application is cited below. The examiner's text directly relevant to the current divisional application is presented in italics.
The most remarkable prior arts of record are as follows:    Kraftson et al. —U.S. Pat. No. 6,151,581    Mohlenbrock et al. —U.S. Pat. No. 5,018,067    Baker et al. —U.S. Publication No. 2006/0161456    Adak et al. —U.S. Publication No. 2004/0242972e
Kraftson teaches data for surveys administered to patients to provide quality of care, but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
Mohlenbrock teaches claims processing to find benefits for patient, but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
Baker teaches eligibility of patients with an insurance plan, but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
Adak teaches recovery scores for treatments plans, but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
Doyle teaches a claims processing system but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
Szilagyi teaches utilization reports of health care services used for treatment, but fails to teach of providing a database of physicians and patients along with the physician's charge for a medical procedure, the outcomes index, prognosis rating of that procedure, historical data with patient outcomes ratings, and recovery score in quality-adjusted life-years; and furthermore creating a treatment plan and comparing the treatment plan to the actual treatment provided to the patient and comparing the recovery score and adjusting the recovery score within the database and then finally comparing the new outcomes index to other providers.
From the above prior art, only Adak and Baker are relevant to the current divisional application. The following patent application is also relevant. G. Brown et al. [U.S. Publication No. 2004/0111278] teaches a computer-implemented method and system for numerically quantifying an individual's loss of quality of life as the result of an accident causing an injury. The approach, based on health-utility analysis, is applied to provide an estimate of the amount of monetary damages in a tort case. The individual's health state prior to the injury, intermediate health states, and remaining life expectancy are associated with health-state utility values of the same or similar health states. These latter are contained in a database of health-state utility values based on interviews of persons actually experiencing these health states. The health-state utility values are each weighted by the length of time the patient spends or is expected to spend in the corresponding health state and then summed up. This value is then compared with the health-state utility value of the patient's pre-accident state multiplied by that person's pre-accident remaining life expectancy. Brown fails to teach creating a set of reference recovery functions (RRFs), which are more consistent with a recovery that occurs as a smooth progression rather than as a series of discrete health states; generating a predicted recovery score by combining the prognosis rating with the RRFs; producing an actual recovery score solely from periodic surveys of the status of the patient's signs and symptoms, and including the patient's longevity; weighting each sign or symptom of the patient with respect to the intensity with which the patient wishes to eliminate the sign or symptom; generating a personal recovery function by interpolating the patient's recovery path with respect to the RRFs; calculating a recovery score as the area beneath the patient's recovery path; calculating an outcomes measure by combining the patient's predicted recovery score with the actual recovery score; and showing how to modify the outcomes measure with respect to the patient's actual life span once the patient expires.
Another relevant patent application is M. Brown et al. [U.S. Publication No. 2007/0179809], which teaches a system and method for performing a cost-utility analysis with respect to pharmaceutical interventions. The focus of this invention is on comparing a plurality of alternative pharmaceutical interventions to determine the optimal intervention, whereas the focus of the current invention is on how well an individual patient recovers following treatment from a medical provider. As with G. Brown, M. Brown fails to teach creating a set of reference recovery functions (RRFs); generating a predicted recovery score by combining the prognosis rating with the RRFs; producing an actual recovery score solely from periodic surveys of the status of the patient's signs and symptoms, and including the patient's longevity; weighting each sign or symptom of the patient with respect to the intensity with which the patient wishes to eliminate the sign or symptom; generating a personal recovery function by interpolating the patient's recovery path with respect to the RRFs; calculating a recovery score as the area beneath the patient's recovery path; calculating an outcomes measure by combining the patient's predicted recovery score with the actual recovery score; and showing how to modify the outcomes measure with respect to the patient's actual life span once the patient expires.
U.S. Pat. No. 5,519,607 (1973), issued to the current inventor, is also a relevant prior art record. This patent teaches an independently produced prognosis rating and a recovery rating, preferably generated by a panel of experts, and comparing the prognosis rating with the recovery rating. However, this patent fails to teach creating a set of reference recovery functions (RRFs); generating a predicted recovery score by combining the prognosis rating with the RRFs; producing an actual recovery score solely from periodic surveys of the status of the patient's signs and symptoms, and including the patient's longevity; weighting each sign or symptom of the patient with respect to the intensity with which the patient wishes to eliminate the sign or symptom; generating a personal recovery function by interpolating the patient's recovery path with respect to the RRFs; calculating a recovery score as the area beneath the patient's recovery path; and calculating an outcomes measure by combining the patient's predicted recovery score with the actual recovery score.
In the published literature, the following volume is also relevant, especially Chapter 6 dealing with Cost-Utility Analysis. Methods for the Economic Evaluation of Health Care Programmes, 3rd Edition by M. F. Drummond, Mark J. Sculpher, G. W. Torrance, B. O'Brien and G. L. Stoddart (Oxford University Press 2005). The Health Utilities Index (HUI) and its variations are presented in this book along with various other methods for evaluating health care programs. The HUI is used primarily to assess the comparative effectiveness of a treatment with respect to alternative treatment methods, whereas the outcomes index developed herein is used to rate medical providers. In the former approach, an outcomes measure is estimated for each medical condition, and a value between 0.0 and 1.0 is assigned to represent the quantity of Quality-Adjusted Life-Years (QALYs) that are lost by an individual who has that medical condition. This source does not teach the methodology that is used to derive each outcomes measure. More importantly, the outcomes measures are not developed for individual risk categories (prognosis-rating groups), as taught by the current invention. The HUI is also based on a fixed survey instrument that is administered to all individuals with the given medical condition. The outcomes measure for the current invention, on the other hand, relies on the specific signs and symptoms experienced by the particular patient, each weighted by the patient's desire to eliminate it, as well as her total loss of QALYs. Although the outcomes index can measure loss of utility in terms of QALYs, it is not used to make interpersonal comparisons among patients, as is the case, if only implicitly, with the HUI. Drummond et al. cites the preference-based health measure from the EuroQol Group [see “Health Policy under EuroQol: A New Facility for the Measurement of Health-Related Quality of Life by the EuroQol Group” (1990).] It, too, uses a fixed survey instrument to assess the quality of life of an individual with a medical condition and differs from the current invention in the same ways that the HUI differs.